A non-government entity
DEVOTED PREMIUM 006 OR (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for DEVOTED PREMIUM 006 OR (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on DEVOTED PREMIUM 006 OR (HMO) in 2026, please refer to our full plan details page.
DEVOTED PREMIUM 006 OR (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Eugene. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that DEVOTED PREMIUM 006 OR (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about DEVOTED PREMIUM 006 OR (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For DEVOTED PREMIUM 006 OR (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $47.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for DEVOTED PREMIUM 006 OR (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The DEVOTED PREMIUM 006 OR (HMO) medicare plan features an annual drug deductible of $615. Tier 1 preferred generic drugs are fully covered with no copay for one-, two-, or three-month supplies at standard pharmacies and standard mail-order. Tier 2 generic drugs require a low copay starting at $3 for a one-month supply, which increases slightly for two- and three-month supplies. Higher-tier medications under this plan are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require 25% coinsurance through standard pharmacies and mail-order. Specialty medications are limited to a one-month supply.
Additional Benefits
The DEVOTED PREMIUM 006 OR (HMO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, preventive services, and home health care. For inpatient hospital stays, there is no coinsurance, though a daily copay of $425 applies for the first four days followed by no copay for days five through ninety. Specialist visits, outpatient hospital services, and emergency care are also covered, with outpatient copays ranging from no copay to $525 and emergency visits requiring a $130 copay. This plan also includes valuable supplemental benefits, featuring dental coverage up to a $3,000 annual limit with no copay for preventive care, and vision benefits providing up to $400 annually for eyewear with no copay. Routine hearing exams are available for a $40 copay, and prescription hearing aids are covered with copays ranging from $199 to $499. Additionally, members receive an over-the-counter allowance of $40 every three months with no copay.
Inpatient Hospital See details
DEVOTED PREMIUM 006 OR (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $425 daily copay for days 1 through 4 and no copay for days 5 through 90. Additional acute stay days are unlimited, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
DEVOTED PREMIUM 006 OR (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay ranging from $0 to $525 (with observation services at a $425 copay per stay), while outpatient substance abuse sessions have a $40 copay and no coinsurance.
Partial Hospitalization See details
DEVOTED PREMIUM 006 OR (HMO) covers partial hospitalization services with a $70.00 copay and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services covered by DEVOTED PREMIUM 006 OR (HMO) require prior authorization, with ground ambulance services requiring a copay ranging from no copay to $310 and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by DEVOTED PREMIUM 006 OR (HMO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a copay ranging from no copay to $45 with no coinsurance, while worldwide emergency services are covered up to a $25,000 limit with copays up to $310 and 20% coinsurance for emergency transportation.
Primary Care See details
DEVOTED PREMIUM 006 OR (HMO) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services feature copays ranging from $0 to $50 and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance (excluding other chiropractic services), but podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by DEVOTED PREMIUM 006 OR (HMO), offering annual physicals, kidney disease education, and other preventive screenings with no copay and no coinsurance. Additional benefits like fitness, weight management, and home safety modifications feature no copay, though alternative therapies and therapeutic massage require 0% to 50% coinsurance. Sub-services not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, adult day health, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
DEVOTED PREMIUM 006 OR (HMO) covers routine hearing exams once per year with a $40 copay and no coinsurance, as well as unlimited fitting evaluations. Up to two prescription hearing aids are covered annually with copays ranging from $199 to $499 and no coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by DEVOTED PREMIUM 006 OR (HMO), featuring one routine eye exam per year with no deductible, a $0 to $40 copay, and no coinsurance, though other eye exam services are not covered. Eyewear is also covered with no deductible, no copay, and no coinsurance, up to a $400 annual maximum limit for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by DEVOTED PREMIUM 006 OR (HMO) up to a $3,000 annual limit, featuring no copay and no coinsurance for preventive, diagnostic, periodontic, and oral surgery care. Restorative, endodontic, and prosthodontic services have no copay and 0% to 50% coinsurance, whereas Medicare-covered dental requires a $40 copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
DEVOTED PREMIUM 006 OR (HMO) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and 0% (no coinsurance) to 20% coinsurance, while Part B insulin requires a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the DEVOTED PREMIUM 006 OR (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
DEVOTED PREMIUM 006 OR (HMO) partially covers medical equipment with no copays, requiring an 18% coinsurance for durable medical equipment, no coinsurance to 20% for prosthetics and medical supplies, and no coinsurance to 18% for diabetic supplies. Prior authorization is required for these benefits, and diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
DEVOTED PREMIUM 006 OR (HMO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copay. Diagnostic tests and procedures feature no coinsurance and copays ranging from no copay to $95, while diagnostic radiological services start with no copay and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
DEVOTED PREMIUM 006 OR (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under DEVOTED PREMIUM 006 OR (HMO) with no coinsurance and require prior authorization, though some services are covered while standard cardiac rehabilitation ($40 copay), intensive cardiac rehabilitation ($40 copay), pulmonary rehabilitation ($35 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
DEVOTED PREMIUM 006 OR (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond day 100 are not covered.
Other Services See details
DEVOTED PREMIUM 006 OR (HMO) partially covers other services, offering acupuncture with no copay and 50% coinsurance, alongside additional preventive services with no copay and no coinsurance. Over-the-counter (OTC) items are also covered with no copay and no coinsurance up to $40 every three months, while meal benefits are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved